By Nicholas Bill | December 12, 2018 Updated 8:04 PM
● Opiates are a class of drugs with high levels of addiction often leading to overdose.
● The high levels of opiate addiction are due, in part, to the policies of the medical community.
● Actions are being taken to disrupt the tide of opiate addiction.
“And now, my beauties, something with poison in it, I think. With poison in it, but attractive to the eye, and soothing to the smell. Poppies.” The Wicked Witch of the West exclaims this in the 1939 film The Wizard of Oz, but unlike the flying monkeys and falling houses, the reference she made was not a fictitious one. The poison being referred to existed in reality, and it permeated American culture so deeply, even to the point of being mentioned in literature and film.
The poison being described is better recognized as a class of substances known as opiates, which are derived from the beautiful poppy plant. Opiates are largely utilized within the healthcare industry to administer pain relief, with other short-term effects being a feeling of euphoria and sedation. All are desirable effects when dealing with a patient undergoing intense pain, but alas, every rose has its thorn.
Opiate thorns are lined with addiction due to the effects of the drug. Opiate users experience a sense of euphoria, considered a “high,” which has been shown to be highly addictive, with addictive tendencies appearing in as little as three days of use. Once addiction sets in, it is often difficult for users to wholly stop taking the drug on their own. This leads to the individual user’s experience of some of the drug’s less desirable, long-term side effects, such as nausea, vomiting, constipation, and brain and liver damage, all of which relate to the consequential dependence on the class of drugs.
However, these long term effects of opiate use are trivial compared to the most devastating issue plaguing America: overdose. Opiate overdoses can occur, even for an attentive drug user, for a number of different reasons, such as the quality of the intended drug; the development of a tolerance; and the intended drug being “laced,” or mixed with other unintended drugs or dangerous chemicals. Individuals overdosing often present slowed or stopped breathing, an inability to wake up, and cold or clammy skin. Opiate overdose requires immediate medical attention to save the life of the individual.
The scourge of addiction and overdose due to opiates has been aptly dubbed “The Opiate Epidemic.” Drug overdose in general was the leading cause of accidental deaths in the United States in 2015, with 52,404 deaths. Of these deaths, prescription pain relievers and heroin accounted for 20,101 and 12,990 deaths, respectively. Opiate addiction and overdose has been an issue for well over a century, as indicated by its reference  in The Wizard of Oz, but today it has reached unparalleled levels. In the past two decades, addiction levels have skyrocketed. The emergency room substance use admission rate increased by 600 percent in the ten years from 1999 to 2009, while the overdose rate increased 400 percent in the same period of time.
While it can be easy to negatively categorize people who become caught in the cycle of addiction, many of these tendencies started after treatment by a medical professional. There is the idea of a drug dealer on the corner providing “tastes” of the drug in order to get potential clients addicted and keep them coming back, but in reality this drug dealer is actually your local pharmacist, and the profiteer is a multimillion dollar company. Four out of every five new heroin users started out misusing prescription pain killers. While the medical community is not the only perpetrator that has driven the use of opiates, it is a large cause of the current epidemic.
The objective of medical care is inscribed in the Hippocratic Oath, an oath taken by all doctors prior to practicing medicine: “I shall help the sick according to my best judgement.” While this judgement is ever changing with new developments, it is what has placed us in the position that we are in now. Throughout the last twenty years, one of the main objectives of the medical community has been pain treatment for patients. Pain was treated through suppression with drugs, and the best available drugs were opiates. It is during this period that a mass prescription of opiates occurred.
In the early 1990s, the number of prescriptions filled for opiates increased by two million each year, with a prescription increase of eight million occurring in 1995 alone. Through the prescription of the drug, people developed addictive tendencies towards the drug. Research over the years has demonstrated the high correlation between prescription use and addiction, allowing the medical community to shift its judgement from pain treatment to pain management. Through the use of pain management, providers are able to reduce the number of opiates they prescribe without leaving patients in their agony. While the idea is sound, many doctors are still in the old mentality, leading to 259 million prescriptions being given out in 2012 alone.
Due to the immense scale of the epidemic, the medical community has been quick to develop and implement methods intended to curb the tide. The first major transition was the switch from pain treatment to pain management, which will hopefully reduce the number of people who become addicted to the drug. In addition, some states have developed a database to keep track of patient records and the drugs that they are prescribed. This database exists to detail to medical professionals whether the patient is a repeat offender seeking drugs instead of needing drugs. The doctor is able to read about every time the patient has received prescription drugs and can use this information to determine whether or not they will prescribe medications. A final method implemented to slow the tide of opiate overdoses is the widespread deployment of narcan, which is a drug used to circumvent opiate overdose after the drugs have been ingested and the process has begun. Each of these methods was developed to influence a different area of opiate abuse, but together they will dramatically help the issue of the opiate crisis.
L. Frank Baum , author of The Wizard of Oz, made the poppy reference a direct one from society; he did not create a fictitious poison, and its sheer mention alone should be an indicator that the issue was so paramount that it needed to be brought to national attention, through the platforms of literature and film. Much like then, the subject should be returned to the national spotlight, for it is of much greater severity than it has ever been. More people are overdosing, and unfortunately closing your eyes and clicking your heels won’t solve it.
The issue needs to be addressed at the root by the American people, much like it was a century ago.
If you or someone you know is undergoing the trials of addiction to opiates, or any other drug, the first step is to realize the problem and to reach out to someone for help, such as the Alcohol and Drug Hotline, reachable at 1-800-821-HELP